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Kidney transplant a long-shot life saver

Kate Hagan

Amity Bishop has a kidney from an incompatible donor, thanks to a new technique. Photo: Simon Schluter

Amity Bishop, 35, had a double lung transplant two years ago after cystic fibrosis caused mucus to build up in her lungs, leaving her to carry around a cylinder of oxygen to help her breathe.

Earlier this year her kidneys failed, and the Elwood woman was so tired she was unable to get out of bed, her face and legs swollen from extra fluid and salt in her tissues.

Doctors worried Ms Bishop's kidney failure would compromise her lung function and make her vulnerable to infections, and she would not survive more than a few months on dialysis.

That made her an urgent candidate for a kidney transplant and, while family members volunteered as live donors, none had the same blood type. A kidney from a donor with an incompatible blood type is quickly rejected. The urgency of Ms Bishop's case led doctors to perform a series of procedures to reduce antibodies in her blood, preventing her body rejecting a kidney donated by her mother.

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The director of renal medicine at The Alfred hospital, Rowan Walker, said a small number of patients had received plasma exchanges to prevent rejection of blood-incompatible kidneys in Australia in the past five years, but he was unaware of any other case in the world involving a lung transplant recipient. ''We weren't sure it was going to behave exactly the same way in someone who was already immunosuppressed and had a lot of fluid in her system … I have to say the team was nervous,'' he said.

''Amity probably would've died within a few months on dialysis, so the options for her were modest, and this was as good a thing as we could come up with.''

In a series of procedures in the two weeks before the transplant, Ms Bishop was hooked up to a machine to remove plasma from her blood, stripping it of antibodies so they would not reject her mother's kidney.

While the antibody levels would rise again in the days after the transplant, Professor Walker said that ''for some reason we don't understand'' the body had by that stage accepted the foreign kidney.

The successful transplant followed months of planning including by lung, kidney, haematology and anaesthetic specialists.

For Ms Bishop the result is feeling better than she has in years, with lung function at 70 per cent, up from 19 per cent before the double transplant, and her new kidney working well.

''I'm thrilled for everyone else it worked out so well. They've all put in so much effort,'' she said. Now, she is looking forward to returning to work and travelling with her mother.